Journey after Brain Anoxia

Angela* was 61 when she had surgery to repair a broken arm. Forty minutes after returning from the recovery room, Angela and her husband Andy* were talking when suddenly, Angela had an anaphylactic allergic reaction to her pain medication. Swelling of her airway tissues prevented nurses from intubating her to provide oxygen. By the time a doctor resuscitated Angela, her brain had been anoxic (starved of oxygen) for about 30 minutes. Andy was informed that Angela was probably brain dead. For a few days, life support was the only thing keeping Angela alive: her heart, kidneys and brain were severely damaged.

Suddenly, Angela began to breathe on her own. Angela was transferred to a nearby long-term acute care hospital for three months. Andy felt that Angela had the best hope for progress if she were at home and treated as close to normal as possible. He prepared their home by installing the required medical and therapeutic equipment and assembling a wonderful team of medical professionals to provide care and therapy. Andy was advised that Angela would probably survive only 4-6 hours if she left the hospital, but time, Andy’s devotion to Angela, and her powerful struggle to survive has proven the doctors wrong.

Angela’s condition appeared unchanged for a year after the surgery. During the second year, she began to move her head, make small movements with her arms and minimal movements with her legs. Andy spent hours talking to her and felt Angela responded to questions through movements of her mouth and other parts of her face. It seemed she was beginning to become aware of others during the last third of that second year.

I first learned about Angela when Andy reached out to me two years after the brain damage. While I had extensive experience working with people with mild to moderate brain damage, I had never worked with someone who had severe brain damage and I was honored and excited to work with her.

During my first assessment, I noticed that Angela’s elbows, wrists and fingers were tightly flexed over her chest, her knees and toes were flexed and her feet rotated inward. She could breathe unassisted through a tracheotomy tube. She had a gastrostomy (feeding) tube for providing nourishment. Angela’s skin color was good, but some areas were grayish. Angela’s CranioSacral Rhythm (CSR) was very slow at around 4 cycles/minute and her entire craniosacral system felt restricted and sluggish. Most striking was how her eyes tracked my movements when I would enter her visual field and I sensed an awareness, alertness and comprehension reflected in her eyes. A literature search revealed that visual tracking is not uncommon after severe brain injury and this experience illuminated some of the difficulties with attempting to determine the veracity of communication in severely brain-damaged people.

I did some energy work to clear and enliven the room where we were working and began to implement the CST 10-step protocol. During my 20-year career, many of my clients had developed brain injury from a mechanical trauma such as a blow to the head. In these cases, some parts of the cranium are typically more restricted than others and it’s often obvious when the CSR optimizes after release of a restriction. In Angela’s case, the restrictions were more diffuse and global. When I reassessed Angela’s CSR near the end of the session, her CSR was in the normal range at 8 cycles/minute.

During the session, I noticed that while Angela’s fingers remained tightly clenched, her elbows and wrists relaxed until her arms rested lightly just above her waist. Her legs relaxed and slowly moved until they were resting against the railing of the shower-bed where she reclined for the session. By the end of the session, Angela’s color was pink, with no tinges of gray. When I stood by her side (outside of her visual field) and spoke to her, her eyes searched for me and tracked my movements.

Since this was my first meeting with Angela, I was unsure if these changes were normal for her. A certified nursing assistant who had worked with Angela several days a week since her hospital discharge two years before, said that Angela was dramatically more relaxed after the session. Apparently, Angela’s arms would often relax when she slept or after showering, but they tightened quickly. The next evening, Andy reported that not only had Angela’s arms maintained their relaxation (her legs were beginning to stiffen up by then), his impression was that her awareness and cognitive abilities had also markedly improved.

I have continued to work with Angela on a weekly basis using CST as well as other techniques such as Chikly’s Brain Therapy and energy work for the past 1.5 months (as of the submission of this manuscript). Due to the extent of Angela’s disabilities, it’s somewhat difficult for me to notice changes in her state, similar to how parents may be the only ones who can understand a small child’s verbal or hand signals when they are learning to talk. In addition to dramatic improvements in her CSR and the tone of her nervous system tissues and associated structures, I do notice how quickly she relaxes at the start of the sessions and I get the feeling that she thoroughly enjoys them.

Andy says “We have seen such a dramatic change in Angela since we began the therapy. I had never heard of CST before. However, I am so glad that I became aware. Angela is extremely alert the evening following the therapy. At the beginning she would decline until the next session. Now she remains mostly alert and aware until the next session. The most amazing change is the way she sleeps. Before the therapy she was just ‘there’ – mouth gaping open, eyes fixed and not responsive. Now when she goes to sleep, she is at peace. When you wake her there is a big yawn and shiny brown eyes. She is progressing so well, we are beginning Occupational and Physical Therapy.“

Angela’s journey since her brain anoxia has been a fierce fight for survival and recovery. Current understanding of consciousness and recovery from severe brain damage is extremely limited and the extent to which she will regain function is unknown. Andy has asked me to continue working with Angela on an ongoing basis and I hope that my manual therapy skills as well as my background in neuroscience will help her in her journey.